Do you want to live forever?

The editorial talks about first, the weak evidence for cause and effect in most observational studies and second, the unspoken assumption in so much popular reporting of medical and nutrition science that we should all strive to live for as long as possible.

On the general uselessness of most observational studies:

One answer, implicit in most media reports, is that acting on the results of the unreliable observational studies “couldn’t hurt and might help.” This makes sense if I have a medical problem for which there is no reliable remedy. If nothing else has helped my arthritis, insomnia or back pain, it would make perfect sense to try a remedy that will not do serious harm and has some probability of working.

But most observational studies concern not remedies for present ills but protection against future ones, and for these cases it is hard to tell if even relatively small costs or risks of harm outweigh the probability of partial protection. More important, there is a reasonable chance that further observational studies will call into question the one I’m acting on or even, as in the case of “good cholesterol,” that rigorous randomized clinical studies may refute it.

As an example, having a high BMI puts us at higher risk for some health problems. Dieting has long been considered a “couldn’t hurt and might help" proposition. However, it may actually be more harmful over the long term than simply maintaining a high, stable weight. In fact, it likely causes long-term weight gain.

Taking a broader view, it would seem preferable to keep healthy by a method that is simple, reliable and doesn’t require constant revision and fine-tuning. We do, after all, have such a method available: simply follow the humdrum standard advice we’ve heard all our lives about eating sensibly, exercising regularly, and having recommended medical tests and exams...

Sure. That advice applies to everyone who is interested in keeping their body running smoothly and in avoiding/controlling medical problems. This is the closest thing we have to a real formula for 'couldn't hurt and might help.' But let's face it...

We are all going to die sometime, from something. Even if I find just the right blend of exercise, diet and herbs that saves me from a heart attack at 60, I may have merely ensured that I will die of cancer at 70. Saving myself from cancer at 70 may mean I end with 10 agonizing years of dementia. When all is said and done, how we die is a crap-shoot, and, short of avoiding obvious risks such as smoking and poor diet, there’s little we can do to load the dice.

And isn't at the root of healthism? Our primitive fear of losing control over our bodies and finally, dying? But it happens to everyone eventually - fat and thin, healthy and unhealthy - and if it didn't, there'd be no room for children and no jobs for young people. So why are we supposed to want to live forever?

Even the so-called scientific studies that say we should do this or that or the other thing have been known to change that advice over the years. Take the one that said cutting down on salt would reduce hypertension - they're now saying that salt may not be the culprit after all, it's probably more genetics than anything else. In other words, if you have a family history of hypertension, then you may end up with hypertension yourself whether or not you use a lot of salt. And if you don't have a family history of hypertension, you probably won't end up with hypertension, no matter how much salt you do or don't use.
The more they study these things, the more they learn - when it's true research and not funded by a pharmaceutical company who is out to sell more drugs to more people based on the outcome of that research.

The desire to lengthen one's life has always mystified me. As they say, you do all the 'right' things, you maybe gain ten years, but they're at the wrong end.

Hubby and I long ago decided that a heart attack is the way to go. Far preferable to cancer or alzheimers or the myriad of other hideous stuff you can get. Sis and I discussed that getting chucked off our horses and dying is also preferable. Makes you wonder why we go around trying to save ourselves from everything sudden just so we can die of something hideous and slow.

And yes salt will be the next thing that suddenly everyone realises is ok and even good for you, especially for those with adrenal fatigue, and who the heck in our society doesn't have some of that? And will those researchers issue an apology to the people who have eaten tasteless foods for decades, and even put their health at risk for lack of salt? No!

Amen to the article's conclusion, re: "crapshoot." I've been telling my family that for years, and not even because of "fat."

Example: My father died last year at age 71 of pancreatic cancer. A lady I know in town lost her daughter to the same disease; the girl was 21. Crapshoot; tragic, terrible, but crapshoot. Disease is not punishment, and it's not as if you can find the magic formula ensuring a long and consistently healthy life.

A few months after Dad's diagnosis, his friend was diagnosed with aggressive gall bladder cancer. He decided to embark on a regimen of fresh made fruit juices and prayers. Did it hurt him? I don't know. (And he eventually did chemo.) Did it cure him? Sadly, no. He passed away Tuesday.

I look to a friend whose father is in his 80s (but sadly, also now with lung cancer, and he is a nonsmoker.) I can't help but ask why my dad couldn't have made it that long — and then I think of another friend who contacted me soon after Dad died, with condolences, but who confided he was "jealous," though, because he was only 15 when his father died. And now a very good, dear friend is facing the loss of his mother, who apparently has terminal lung cancer AND bone cancer. She is only 52.

And there was a dear, sweet couple who worked out together every day in my gym; they were a bit older, but hardly ancient. One day a few months back, she came into my office without him. She was in tears. He had just died of a heart attack.

And when I drive home tonight, I could be in a fatal car crash, murdered in the alley where I park, or fall off a ladder in my home. Or a piano could drop on me out of the clear blue sky. Point is, the only guarantee about life is that it's eventually fatal. As my father often said "I've been dying since the day I was born."

The only thing we can do is our best to make sure our lives are as full and rich as possible without harming others, and that we also enrich others. This will vary by person. Some of us pursue enrichment in extreme ways; most of us fall in the middle.

It's like they say, and I don't mean to be cavalier here, but: "Eat well. Work out. Die anyway."

Health zealots have turned me off longevity the way fundamentalists turn people off religion. Ironic that we have been nagged all our lives to eek out every last millisecond, but social security and medicare won't be there for us. I have to laugh at all those who denied themselves pleasure, FOR WHAT? To end up impoverished in old age? And of course, either the Gulf pollution (more oil has been found 8/11) or the radiation from Fukushima will get us anyway!